世界中医药

目的：挖掘干燥综合征合并肺间质病变（SS-ILD）与未合并肺间质病变（SS-NILD）住院患者之间的临床差异，为SS-ILD的早期诊断及后续临床治疗提供客观理论支持。方法：收集符合标准的SS-ILD和SS-NILD住院患者的临床资料，对基本信息、临床表现、证型舌脉、实验室检查、治疗方案等进行统计分析。结果：共纳入299例患者，其中SS-ILD组87例，SS-NILD组212例。SS-ILD组年龄、有烟酒史、有呼吸系统症状、舌苔无或剥脱、脉象弱的概率较高，氧分压水平较低，红细胞沉降率、C反应蛋白水平及类风湿因子阳性率较高；辨证为阴虚津亏、气阴两虚、燥瘀互结的患者合并ILD的比例较高（P<0.05）。回归分析结果表明：合并ILD与吸烟史、主诉咳嗽、舌苔无或剥脱、弱脉及气阴两虚证呈正相关，与主诉眼干呈负相关。SS-ILD肺功能检查以轻度阻塞性/限制性通气功能障碍和轻度弥散功能障碍为主，胸部高分辨CT主要表现为胸膜增厚、结节影、磨玻璃影。SS-ILD所用中成药以虫草类制剂为主，SS-NILD以雷公藤类制剂为主；西医用药以免疫抑制剂为主，或与中效糖皮质激素联合应用。结论：SS住院患者多为高龄中老年女性，有吸烟史及呼吸系统症状、中医辨证为气阴两虚是合并ILD的相关因素，临床用药以抗炎、调节免疫为目标，生物制剂仍需进一步推广应用。

English Summary:

To explore the clinical differences between inpatients with Sjgren's syndrome and interstitial lung disease(SS-ILD) and those without interstitial lung disease(SS-NILD)，providing objective theoretical support for the early diagnosis and subsequent clinical treatment of SS-ILD.Methods:Clinical data from inpatients with SS-ILD and SS-NILD meeting the inclusion criteria were collected.Statistical analysis was conducted on basic information，clinical manifestations，syndrome types based on tongue and pulse diagnosis，laboratory tests，and treatment regimens.Results:A total of 299 patients were included，with 87 in the SS-ILD group and 212 in the SS-NILD group.The SS-ILD group had a higher probability of being older，having a history of smoking and alcohol use，experiencing respiratory symptoms，having no or desquamated tongue coating，and having weak pulses.This group also had lower oxygen partial pressure，higher erythrocyte sedimentation rate，C-reactive protein levels，and rheumatoid factor positivity rates.Patients diagnosed with the syndromes of yin deficiency with fluid depletion，qi and yin deficiency，and dryness in combination with stasis had a higher likelihood of ILD(P<0.05).Regression analysis indicated that ILD was positively correlated with smoking history，cough as the primary complaint，no or desquamated tongue coating，weak pulse，and qi-yin deficiency syndrome，and negatively correlated with dry eye as the primary complaint.Pulmonary function tests in the SS-ILD group mainly showed mild obstructive/restrictive ventilatory dysfunction and mild diffusion dysfunction.High-resolution chest CT in SS-ILD patients primarily showed pleural thickening，nodular shadows，and ground-glass opacities.The main Chinese patent medicines used in the SS-ILD group were formulas containing Cordyceps，while the SS-NILD group predominantly used Tripterygium wilfordii-based preparations.Western medicine treatments were mainly immunosuppressants，or a combination of intermediate-acting glucocorticoids.Conclusion:Hospitalized SS patients are primarily elderly women with a smoking history and respiratory symptoms.Traditional Chinese medicine diagnosis of qi-yin deficiency is associated with the presence of ILD.Clinical treatment focuses on anti-inflammatory and immune-regulatory therapies，with further promotion of biologics still needed.

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